Teaching of major communicable diseases in Sudanese medical schools: a critical look

This descriptive, cross-sectional study of Sudanese medical schools aimed to describe and analyse the proportion of their curricula currently allocated for teaching of communicable diseases and to assess the teaching methods and student assessment tools. Qualitative and quantitative data were collected from heads of departments and students in 20 of the 27 medical faculties and from ministry of health staff at federal and state levels. Curriculum designs ranged from traditional to innovative, community-oriented programmes. Problems regarding student evaluations were identified. Major limitations included shortages of staff, reference materials and teaching aids. Poor knowledge of students about different aspects of diseases endemic in Sudan was found. Recommendations include curriculum development, staff recruitment and training, and improvement of teaching and training of students

Prevalence of hepatitis C virus [HCV] antibodies in patients with schistosomaisis

This study comprised 850 subjects from three villages in the Gezira area in the central region of the Sudan. Faeces and urine specimens collected from the above subjects were examined for Schistosoma mansoni and S.heamatobium. One hundred and six individuals were confirmed positive, 49 [46.2%] with S.mansoni, 50 [47.2%] were infected with S.heamtobium and 7 [6.6%] with mixed infection. Of the 106 serum samples obtained from schistosoma-infected subjects and 100 serum samples from control subjects were tested by ELISA, 33 [31.1%] and 4 [4%] were found reactive for HCV antibodies respectively. These results showed strong association between schistosomaisis and HCV, which may suggest that schistosoma infection is a cofactor in HCV infection in patients with Bilharsiasis. A further study of large population size is highly recommended in order to draw a conclusion in the association between HCV and schistosoma infections

Epidemiologial studies on toxoplasmosis in pregnant women using serological methods in Gezira state-central Sudan

To study the relationship between toxoplasmosis and the outcome of pregnancy [full term and abortion] and to find out the epidemiological risk factors. This case control study was carried out at Wad Medani Teaching hospital, Gezira State, Central Sudan during the period March 2002-May 2004. The cases were 100 pregnant women who presented with abortion between the second and fourth months of gestation, and the controls were 100 full term normally delivered ELISA lgG test [n = 94 in each group] revealed 35.1% and 39.4% seroprevalence rates in the study and control groups respectively with no significant difference [p=0.6]. When performed on IgG seropositives, ELISA IgM seroprevalence rates were 15.2% and 16.2%, in the study and control groups respectively. Statistically, there was no significant difference between them [p=0.9]. When correlated to sociodemographic characteristics and risk factors, Toxoplsma gondii seroprevalence showed significant relationship for age, education, occupation, parity and past history of congenital malformations in both groups. There was significant difference between the two groups for ethnicity. The most important risk factor in both groups was the intake of raw meat [herbivorous viscera]. The findings of this study suggests that, ingestion of infected raw meat is an important risk factor for toxoplasmosis. [OR, 3.87; 95%CI, 1.59-9.44] in the study group, while in the control group [OR, 4.41; 95%CI, l.76-11.09]

Fine needle aspiration cytology [FNAC] in diagnosis of tumoral calcinosis, a report of three cases

Tumoral calcinosis [T.C.] is very rare and generally of unknown aetiology characterized by calcific deposits in the soft tissues. Commonly seen in the second decade of life [reported age range 15 months to 83 years]. We are reporting 3 cases of T. C. who were initially diagnosed by FNAC. Two of the 3 cases were female siblings who were referred to us as possible cases of recurrent fibrosarcomas following surgical excision. [1] Two female siblings aged 17 and 14 years - complaining of large swelling in the upper outer right thigh and the left outer upper thigh around the hip joints respectively. There was no limitation of movement. The masses recurred within a short period after total excision. Neither specimen was subjected to histopathology. Clinical examination showed two masses each approximately 30cm maximum diameter and 10 cm width. In addition the younger sister showed an additional mass 4.5 cm in the outer aspect of her right elbow. [2] 18 months old female child, unrelated to the above two cases, presented with an egg-sized mass in the mid-lateral aspect of her right thigh - cystic and mobile. There is a history of quinine injection in the same area. No positive family history of a similar condition. All three cases showed normocalcaemia and hyperphosphataemia with specks of calcification on x - ray and cysts in ultrasound. FNAC showed structureless gung, calcium granules and inflammatory cells including foreign body type multinucleated giant cells. Histopathology confirmed the diagnosis of T. C. Described the three types of T. C. [familial, idiopathic, and that in patients of chronic renal failure on dialysis]. The differential diagnoses were also discussed as well as lines of management such as Ca[++] supplementation, phosphate restriction, acetazolamide, parathyroidectomy and the treatment of choice is total surgical excision. To our best knowledge this is the first time to report the use of fine needle aspiration cytology in the diagnosis of T. C. in Sudan

Immunochromatographic test for Plasmodium falciparum malaria in Medani, central Sudan

the aim of this study was to evaluate the newly introduced immunochromatographic test [ICT] for falciparum malaria. The measurement of the disappearance time of the falciparum specific antigen [Pf HRP-2] following the eradication of malaria was included in the study. the study included 35 patients, 18 males and 17 females, with an age range of 12-55 years selected by experienced physicians. 31 of the patients were positive for P. falciparum both by ICT and microscopy. Two were positive by microscopy and negative by ICT; these proved to be due to P. vivax and were excluded from the study. One case was positive by ICT and negative by microscopy. This case responded very well to antimalarial treatment. The final case was negative by microscopy and ICT and was excluded from the study. Cases were treated with the antimalarials chloroquine, fansidar, quinine, and the new Chinese herbal antimalarial, artemether. Overall the Pf HRP-2 disappeared in 80% of the cases during immediately after, or 3 days after the end of the treatment. Conclusions: this study confirms other reports that ICT is sensitive, specific, and easily performed. The disappearance time of the Pf HRP-2 antigen raises interesting points regarding the epidemiology and the follow up of malaria cases

Spontaneous splenic rupture and falciparum malaria in central sudani a report of nine cases with review of literature

The clinical, laboratory, and operative findings of nine cases of spontaneous rupture of the spleen due to P.falciparum malaria are presented. They all occurred in a period of six months [October 1993 to March 1994]. No previous reports were found in Sudanese literature. Worldwide, there are a number of case reports mainly due to P. vivax and in non - immune, acutely infected international travelers. Very few cases were due top falciparum. Only 11 cases were reported due to falciparum malaria in a review of literature in the period from 1960 to 1991. A review of the literature is presented with a discussion of possible pathogenesis and various approaches to management

Congenital erythropoietic porphyria [CEP] a report of two female siblings

Congenital erythropoietic porphyria [CEP] is a rare inherited condition. Two sisters with this disease, 12 and 4 years of age, presented with discoloration of the teeth and hyperpigmentation of the sun exposed areas of the skin. Hypertrichosis, vesicular rash, mutilation of the finger tips, and splenomegaly were also observed. Both passed red urine which was positive for uroporphyrin 1 under UV light. The diagnosis was confirmed with high levels of uroporphyrins and coproporphyrins in a 24 hour specimen Interestingly, there is no known family history of this disorder. These are the first cases of CEP recorded in Sudan. The symptoms improved significantly with avoidance of exposure to sunlight